0003 Nocturnal Wakefulness Is Associated with Altered Macronutrient Intake in a Nationally Representative Sample

Abstract Introduction The “Mind After Midnight" hypothesis suggests that being awake at night is associated with cognitive/affective dysregulation and impaired decision-making. Previous work identified risks associated with suicide. The present study examined whether nocturnal wakefulness is associated with aberrant food intake. Methods Data were extracted from the National Health and Nutrition Examination Survey (NHANES) 2015-2016 and 2017-2020 pre-pandemic waves (N=13,995). Multivariate linear regression estimated the relationship between hours of wakefulness from 11pm-5am (predictor) and multiple dietary outcomes. Models were unadjusted and adjusted for age, sex, race/ethnicity, employment status, education, and self-reported total sleep duration. In some cases, models were additionally adjusted for total caloric intake. Results There were significant differences in the sex, age, race/ethnicity, education, and total sleep duration of individuals who experienced more nocturnal wakefulness (all p< 0.001). Duration of nocturnal wakefulness was not associated with total caloric intake in unadjusted or adjusted models. Greater time spent awake during the night was associated with less protein intake (adjusted β=0.96, p=0.004), more sugar intake (unadjusted β=2.9, p=0.012; adjusted β=2.6, p=0.004) and less fiber intake (unadjusted β=0.49, p=< 0.001; adjusted β=0.35, p=0.005) after adjusting for total caloric intake. There was also a trend toward greater intake of saturated fats (adjusted β=0.19, p=0.083). Conclusion Our study shows that individuals with greater nocturnal wakefulness have higher intakes of nutrients that are frequently found in more highly processed foods, such as added sugar and saturated fats, and fewer nutrients found in healthier dietary options, such as fiber and protein. The dietary profile of individuals with higher nocturnal wakefulness may predispose them to chronic conditions. The propensity for unhealthy eating when awake during the biological night may be an important and underexplored public health concern. Support (if any)